哮喘儿童睡眠障碍的机制及研究进展

Mechanism and progress of sleep disorder in asthmatic children

睡眠障碍在哮喘患者中非常普遍,尤其是严重哮喘患者。睡眠障碍与哮喘控制和生活质量较差有关。哮喘患者的睡眠障碍可能与气道生理及炎症反应的昼夜变化有关,但也可能与特定的睡眠障碍有关,如阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)、胃食道反流、肥胖、心理问题等。哮喘合并阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)又称为重叠综合征,发病率较高。OSA是哮喘控制不良的独立危险因素,同时哮喘会加重OSA,二者形成一种恶性循环。在治疗哮喘的同时,治疗合并症尤为重要。持续气道正压(continuous positive airway pressure,CPAP)治疗OSA可改善哮喘患者的睡眠障碍及生活质量。

Sleep disorder is common in patients with asthma,especially in patients with severe asthma.Sleep disorder correlates with poor asthma control and poor quality of life.Sleep disorder in asthmatic patients may be related to the circadian variation in airway physiology and airway inflammation,but may also be related to specific sleep disorders such as obstructive sleep apnea(OSA),gastroesophageal reflux,obesity,psychological problems,etc.OSA is an independent risk factor for poor asthma control.At the same time,asthma will aggravate OSA.Treatment of OSA with continuous positive airway pressure(CPAP)may lead to improved asthma-specific quality of life.